to analyze the findings of both pH impedance (MII-pH) and endoscopy/histopathology in children with esophageal atresia at the age of one year, according to current recommendations for the diagnosis of gastroesophageal reflux disease (GERD) in EA.
We retrospectively reviewed both MII-pH and endoscopy/histopathology performed in one-year-old EA children, followed-up according to international recommendation. Demographics and clinical characteristics were also reviewed to investigate factors associated with abnormal GERD investigations.
We included 48 children with esophageal atresia. Microscopic esophagitis was found in 33/48 patients (69%), and pathological esophageal acid exposure on MII-pH was detected in 12/48 (25%). Among baseline variables, only the presence of long-gap EA was associated with abnormal MII-pH. Distal baseline impedance was significantly lower in patients with microscopic esophagitis, and it showed a very good diagnostic performance in predicting histological changes.
histologic esophagitis is highly prevalent one year after EA repair, but our results do not support a definitive causative role of acid-induced GERD. Instead, they support the hypothesis that chronic stasis in the dysmotile esophagus might lead to histological changes. MII-pH may be a helpful tool in selecting patients who need closer endoscopic surveillance and/or benefit from acid suppression.
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